Does unit design impact delivery of care? In 1863, Nightingale described four elements of design which she considered essential to nursing efficiency (Gainsborough, 1970). Today, 128 years later, nursing is still grapling with this same issue. Recent studies have looked at how the lay-out of the unit can affect staffing patterns, travel time, employee and patient satisfaction, supervision and nurses perception of their work environment (Shukla, 1982; Feldstein, 1983; Ferris and Rowland, 1985; Herzog, 1985; Porter and Watson, 1985; Strasen, 1987). The purpose of this study was to examine the relationship between unit design and (1) the delivery of efficient and effective delivery of quality care to satisfied clients; (2) the nursing staffs' perception of their work environment.

A convenience sample of four acute care hospitals was used for this explanatory, non-experimental study. The variables examined were selected using the Systems Model of Nursing Productivity (Cherry, 1990). Two of the facilities' physical typologies consisted of circular or cluster units with the patient rooms no more than 36 feet from the nurses' station. The other two had long rectangular units with patient rooms as far away as 100 feet. Data were collected over a seven month period using the Rush-Medicus Quality of Care tool (Haussman, Hegyvary and Neumann, 1976), the LaMonica Oberst Patient Satisfaction Scale (LaMonica and Oberst, 1986), Moos's (1986) Work Environment Scale and a measure of efficiency developed by the investigator. The following significant findings were identified between the rectangular (R) and circular/cluster (C/C) units.

1. The C/C designed units had a significantly higher mean quality care score (u=81.56) (p=.000) than units with R designed units (u=73.30).

3. The nurses' perception of peer cohesion on the R units was significantly higher (u=54.71) (p=.006) than the C/C units (u=44.75).

4. The nurses perception of physical comfort was significantly higher in the C/C group (u=67.65)(p=.005) than the R group (u=52.1).

The essential elements of unit design identified by Nightingale are still relevant today. The findings from this study identified both pros and cons of a circular versus a rectangular facility. Through additional nursing research, unit designs which can best provide the desired outcomes of efficient and effective delivery of care can be identified. Then and only then, will nursing be able to justify a specific structure based on desired outcomes, when new facilities are constructed.

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Language

dc.type

Presentation

en_GB

dc.title

The impact of unit design: Rectangular versus circular/cluster

en_GB

dc.identifier.uri

http://hdl.handle.net/10755/148502

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dc.description.abstract

<table><tr><td colspan="2" class="item-title">The impact of unit design: Rectangular versus circular/cluster</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1991</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Krepper, Rebecca, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Texas Woman's University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jimrebk@aol.com</td></tr><tr><td colspan="2" class="item-abstract">Does unit design impact delivery of care? In 1863, Nightingale described four elements of design which she considered essential to nursing efficiency (Gainsborough, 1970). Today, 128 years later, nursing is still grapling with this same issue. Recent studies have looked at how the lay-out of the unit can affect staffing patterns, travel time, employee and patient satisfaction, supervision and nurses perception of their work environment (Shukla, 1982; Feldstein, 1983; Ferris and Rowland, 1985; Herzog, 1985; Porter and Watson, 1985; Strasen, 1987). The purpose of this study was to examine the relationship between unit design and (1) the delivery of efficient and effective delivery of quality care to satisfied clients; (2) the nursing staffs' perception of their work environment.<br/><br/><br/><br/>A convenience sample of four acute care hospitals was used for this explanatory, non-experimental study. The variables examined were selected using the Systems Model of Nursing Productivity (Cherry, 1990). Two of the facilities' physical typologies consisted of circular or cluster units with the patient rooms no more than 36 feet from the nurses' station. The other two had long rectangular units with patient rooms as far away as 100 feet. Data were collected over a seven month period using the Rush-Medicus Quality of Care tool (Haussman, Hegyvary and Neumann, 1976), the LaMonica Oberst Patient Satisfaction Scale (LaMonica and Oberst, 1986), Moos's (1986) Work Environment Scale and a measure of efficiency developed by the investigator. The following significant findings were identified between the rectangular (R) and circular/cluster (C/C) units.<br/><br/><br/><br/>1. The C/C designed units had a significantly higher mean quality care score (u=81.56) (p=.000) than units with R designed units (u=73.30).<br/><br/>2. R designed units had a significantly higher mean patient satisfaction score (u=81.74) (p=.000) than C/C design (u=72.61).<br/><br/>3. The nurses' perception of peer cohesion on the R units was significantly higher (u=54.71) (p=.006) than the C/C units (u=44.75).<br/><br/>4. The nurses perception of physical comfort was significantly higher in the C/C group (u=67.65)(p=.005) than the R group (u=52.1).<br/><br/><br/><br/>The essential elements of unit design identified by Nightingale are still relevant today. The findings from this study identified both pros and cons of a circular versus a rectangular facility. Through additional nursing research, unit designs which can best provide the desired outcomes of efficient and effective delivery of care can be identified. Then and only then, will nursing be able to justify a specific structure based on desired outcomes, when new facilities are constructed.</td></tr></table>

en_GB

dc.date.available

2011-10-26T09:46:07Z

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dc.date.issued

2011-10-17

en_GB

dc.date.accessioned

2011-10-26T09:46:07Z

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dc.description.sponsorship

Sigma Theta Tau International

en_GB

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